Apparatus for imposing a respiration cycle on a patient, and in particular to induce psychosomatic relaxation



Nov. 23, 1965 E. GIORDANO APPARATUS FOR IMPOSING A RESPIRATION CYCLE ONA PATIENT, AND IN PARTICULAR TO INDUCE PSYCHOSOMATIC RELAXATION 5Sheets-Sheet 1 Filed July 24, 1962 D m N G Pm n 0 E A VII m.

Nov. 23, 1965 E. GIORDANO 3,219,028

APPARATUS FOR IMPOSING A RESPIRATION CYCLE 0N A PATIENT, AND INPARTICULAR To INDUCE PSYCHOSOMATIC RELAXATION Filed July 24, 1962 5Sheets-Sheet 2 INVENroH ETIENNE MORO/Wa r ATTORNEY Nov. 23, 1965 E.GIORDANO 3,219,028

APPARATUS FOR IMPOSING A RESPIRATION CYCLE 0N A PATIENT, AND INPARTICULAR TO INDUCE PSYCHOSOMATIC RELAXATION Filed July 24, 1962 5Sheets-Sheet 3 Fig. 3

\N VENTOR ETKENNE G'IRDHNO Nov. 23,` 1965 E. GIORDANO APPARATUS FORIMPOSING A RESPIRATION CYCLE ON A PATIENT, AND IN PARTICULAR TO INDUCEPSYCHOSOMATIC RELAXATION Filed July 24, 1962 5 Sheets-Sheet 4 NEYS ENov. 23, 1965 E. GIORDANO 3,219,028

APPARATUS FOR IMPOSING A RESPIRATION CYCLE ON A PATIENT, AND INPARTICULAR To INDUCE PSYCHOSOMATIC RELAXATION Filed July 24, 1962 5Sheets-Sheet 5 INVENTOR TI E NNE GPIORDNO HTTDRNE YS APPARATUS FORIMPGSING A RESPIRATION CY- CLE N A PATIENT, AND IN PARTICULAR T0 INDUCEPSYCHOSOMATIC RELAXATION Etienne Giordano, 63 Rue du Chateau dEau,Paris, France Filed July 24, 1962, Ser. No.212,016 8 Claims. (Cl. 12S-1)The present application is a continuation-in-part of my copendingapplication Serial No. 64,777, led on October 25, 1960, entitled:Apparatus for Imposing a Respiration Cycle on a Patient, and inParticular to Induce Psychosomatic Relaxation, now abandoned.

This invention relates to an apparatus for imposing a respiration cycleon a patient and in particular to induce psychosomatic relaxation.

The natural human physiological rhythm is about cycles per minute for aventilation of 300 to 500 cubic centimeters per cycle, namely, 5 to 7litres of air passed through the lungs in one minute.

In all psychosomatic methods such as relaxation, painless childbirth,etc., the aim is, on the one hand, to assist mental and physicalrelaxation by gradually slowing down the breathing rhythm, awareness -ofthe change in rhythm being ensured by means of periods during which thebreath is held, and, on the other hand, as the rhythm gradually slowsdown, to compel oneself to breathe more deeply and more amply, 'so as toproduce a lung ventilation that is greater than the natural automaticventilation.

Pieces of apparatus of this type have been resorted to before, in whichprovision is made for the displacement of a luminous spot in ato-and-fro linear motion, the patient adjusting :the rhythm of hisbreathing to displacement of the spot. Displacement of this spot isobtained by mechanical means ensuring the alternating translation, of anassembly consisting mainly of a lamp and a screen, behind a slit in theapparatus.

An apparatus of the type described above has the drawback thatdisplacement of the spot takes place in continuous fashion, so that thepatient is able only to alternate inhalation and exhalation phases. Forcertain applications, however, it is necessary to provide, between theexhalation phase and the next inhalation phase (or vice-versa), a phaseduring which the patient holds his breath.

The chief object of the present invention i-s to provide an apparatuspermitting visualization of a full respiration cycle in which thebreath-holding phases are inserted between the inhalation and exhalationphases.

It is yet a further object of the invention to provide an apparatus inwhich the luminous trace which a patient must follow with his eyes mayhave any desired geometrical pattern differing from a straight linesection.

The description which follows with reference to the accompanying drawingof the present invention will give a clear understanding of how thelatter may be performed.

In the drawing:

FIGURE l is a perspective view of the front face of the apparatus.

FIGURE 2 is a rear elevation view of the apparatus the casing beingassumed to have been removed.

FIGURE 3 is a side elevation view as seen from the righthand side of theapparatus, the lateral panel of the casing being assumed to have beenremoved.

FIGURE 4 is a vertical sectional view taken through the lines, IV-IV ofFIG. 2.

FIGURE 5 is a fragmentary and highly diagrammatic View of the deviceused to drive one of the mobile screens.

FIGURE 6 is a simplified persepective view illustrating the manner ofoperation of the apparatus; and

FIGURE 7 is an electrical wiring diagram.

l United States Patent O 3,219,028 Patented Nov. 23, 1965 ice Referringto FIGURES 1 to 7, the embodiment of the apparatus shown thereonbasically comprises a casing 101 closed by a cover 102. When theapparatus is open (see FIG. l), it will be seen that its front portionis equipped with a board 103 on which the luminous images appear, and,below said board, with a compartment housing the supply lead 104 and aconductor 105 connected to the remote control device 106. At the centerof board 103 are positioned a timer control knob 107 and a luminoussource 108 providing intermittent or continuous light adapted to beplaced in circuit or not by means of a knob 109. A further knob 110controls a lil-ter selector to allow the color of the luminous source tobe changed.

Said board 103 is provided with windows, to wit, two Vertical windows111 and 113 and two horizontal windows 112 and 114 which form arectangle. These windows can obviously be arranged diterently ifdesired. Window 111 is associated to the inhalation phase of thebreathing cycle and window 113 lto the exhalation phase, while windows112 and 114 are associated to the breathholding phases betweeninhalation and exhalation.

Referring now to FIGURES 2, 3 and 4, it will be seen that behind windows111 to 114 are respectively positioned assemblies consisting of:semi-cylindrical screens 115, 117, 119 and 121 on the one hand, andlamps 116, 118, 120 and 122 on the other hand. The lamp 116 illuminateswindow 111 and the light rays from said lamp can be occluded by mobilescreen 115. Similarly, lamps 118, 120 and 122 respectively illuminatewindows 112, 113 and 114, the light rays from which lamps can beoccluded by screens 117, 119 and 121.

The various moving parts of the apparatus are driven by amotor/reduction gear 123, the output shaft 124 of which mounts a firstpinion 125 coupled in driving relation to said timer (which timer willbe described in greater detail hereinafter) and two further drivingpinions 126 and 127 which transmit the motion through intermediatepinions 128 and 129 to driven pinions 130 and 131 rigid withintermediate shaft 132. Said intermediate pinions 128 and 129 aremounted on a pivotal support 133 controlled by a linkage system which isgenerally designated by neference numeral 134 (see FIGURE 4), therebyallowing for the selection of either of two transmission ratios betweendrive shaft 124 and intermediate shaft 132.

Each of a plurality of speed selection electromagnets 141 and 142 146controls the motion of an intermediate pinion 177 which, when thecorresponding electromagnet is energized, is brought into mesh with apair of pinions 178 and 179 which are respectively rigid withintermediate shaft 132 and driving shaft 135. In the specific exampleconsidered for illustrative purposes, wherein it is possible to selecteither of six operating speeds, i.e. six diferent respiration cycletimes, intermediate shaft 132 and driving shaft 135 support six pairs ofmeshing pinions such as pinions 178 and 179. Driving shaft 135 is thusrotated by intermediate shaft 132 at a relative speed which will dependon whichever of electromagnets 141 to 146 is energized, or, moreprecisely, on the pitch circle diameters of pinions 177, 178 and 179associated to that particular electromagnet.

On its extremities, driving shaft 135 carries two pinions `136 and 137,which are respectively adapted to rotate the cylindrical screens 115 and119. A description will now be given, with particular reference toFIGURE 5, of the mechanism for driving one of the horizontal-axiscylindrical screens. Screen 115 is rigid with a shaft 138 onto which iskeyed a pinion 139 meshing with an intermediate pinion 147. Saidintermediate pinion is mounted on one of the arms of a pivotal lever 148fulcrumed about the shaft 138. The pivotal motion of lever 148 iscontrolled by anengagement electromagnet 149 which is biased by a returnspring 150. When electromagnet 149 is energized, it pivots lever 148 inan anticlockwise direction with 'reference to FIGURE 5 and shiftsintermediate pinion 147 into engagement with pinion 136, thereby causingthe rotation of driving shaft 135 to be transmitted to the shaft 138 ofdrum 115 through the instrumentality of pinions 136, 147 and 139.

The clutch or engagement mechanism of the other 'cylindrical screen 119is identical to this clutch mechanism and is controlled by anelectromagnet 151. When they reach the end of their travel, cyclindricalscreens 115 and 119 operate through pegs 115g and 119a on reversingcontacts 152 and 153, the functions of which will be specified ingreater detail when the electrical wiring diagram of the apparatus isexamined hereinbelow.

Semi-cylindrical screens 115 and 119 respectively drive 'thevertical-axis semi-cylindrical screens 117 and 121 through a cable andpulley system. As may be seen in FIGURE 2, the shaft 138 of drum 115 isrigid with a pulley 154 over which runs a cable 155, which cable alsoruns over a pulley 156 rigid with the vertical shaft 157 of screen 117.A second pulley 158 is keyed to said shaft 157, and this pulleycooperates with a cable 159 fastened to a return spring 160. Pulleys 156and 158 are mounted eccentrically on shaft 157, in such a manner thatthe rotation of screen 117 produces a substantially constant rate ofdisplacement of the illuminated section of window 112.

In like manner, semi-cylindrical screen 119 controls the motion ofscreen 121 through a similar combination of component parts.

In order to insure a constant rate of displacement of 'the illuminatedsection of windows 111 and 114, it will be of advantage, as shown inFIGURE 3, to mount lamps 116 and 120 on a stirrup 161 which pivots abouta shaft 162. Said stirmp 161 is connected by a link 163 to a lever 164which pivots about shaft 165 and supports a follower 166, which followercooperates With a cam 167 which is angularly rigid with cylindricalscreen 115. As a result of this disposition, when drum 115 rotates, thearm 161 carrying lamp 116 has imparted to it an oscillating motion whichis designed to compensate for fluctuations in the rate of travel of theilluminated window area and cause it to remain substantially constant.

As stated precedingly, the apparatus is equipped with a timer which isdriven, through the medium of a transmission gear train generallydesignated by reference numeral 170 on FIGURE 4, by the pinion 125 rigidwith driving shaft 124. The output shaft 171 supports a pinion 172 whichcontrols the pivotal motion of a peg 173 which operates a master limitswitch 174.

The light source 108 (see FIGURE 4) comprises a lens which isilluminated by a lamp 175 positioned behind a colored filter support lnwhich can be rotated by means of a knob 110.

The apparatus according to this invention will now be described withparticular reference to the schematic illustration of FIGURE 6 and theelectrical wiring diagram of FIGURE 7. Having placed the timer knob 107in the position corresponding to the required duration of the exerciseand the master switch 174 being closed, the operator presses one ofpush-buttons 141:1, 142a 146a of the remote control device 106,according to whichever of electromagnets 141, 142 146 is to beenergized. To each pushbutton 141a to 146a there corresponds a fixedrespiratory cycle duration. If pushbutton 141:1 is depressed,electromagnet 141 will be energized and the intermediate pinion 177associated thereto will transmit the motion through the correspondingpinions 178 and 179, thereby causing driving shaft 135 to be driven offthe input shaft 124 with the chosen demultiplication ratio.

To initiate operation, the operator must press an additional pushbutton180 which is associated to the remainder of pushbuttons 141a to 146a inthe remote control unit 106. Closure of contact 180 causes electromagnet149 to be energized, since contact 172 is in the inoperative position.Contacts 149g and 14911 of electromagnet 149 then close, the former ofsaid contacts insuring continued energization of electromagnet 149 andthe latter switching the current supply through to lamps 116 and 118.Thenceforward, these two lamps will emit light rays which, however, willbe occluded by the respective screens an-d 117.

As explained precedingly, energization of engagement electromagnet 149results in the shaft 138 of semi-cylindrical screen 115 being set inrotation, thereby causing the latter to be rotated in an anticlockwisedirection with reference to FIGURE 3. During this motion, lamp 116 isprogressively unmasked and a luminous area of progressively increasingheight is projected on the vertical window 111.

When the lighted section of window 111 has progressed to the upperextremity of said window, the semi-cylindrical screen 117, which isrotated at the same time as screen 115, begins to unmask lamp 118, whichlamp then begins to project a beam of light on to the horizontal window112, this beam in turn producing a progressively increasing illuminatedsection. When this latter section has reached the extremity of window112, screen 115 acts on contact 152 through peg 115a and causes it tomove into its operative position. If reference be now had to FIGURE 7,it will be seen that rendering contact 152 operative causes energizationof the second engagementelectromagnet 151 associated to screen 119. Thischange of state of contact 152 furthermore cuts off the continuedenergization of electromagnet 149 and thereby causes extinction of lamps116 and 118. At the same time, semicylindrical screens 115 and 117revert to their inoperative positions in response to return springs 160.

Excitation of engagement-electromagnet 151 results in closure ofcontacts 115a and 151b, the former of which contacts controls continuedenergization of electromagnet 151 when contact 153 is in its inoperativeposition and the latter switches through the current supply to lamps and122. Simultaneously, engagement electromagnet 151 causes rotation ofscreen 119 and correlative rotation of screen 121. In their inoperativepositions, screens 119 `and 121 are so disposed that they do not occludethe light rays from lamps 120 and 122, so that as soon as contact 152 istransferred to its operative position by screen 115, the lamps 120 and122 illuminate the entirety of windows 113 and 114. Simultaneously,lamps 116 and 118 are extinguished, thereby causing the illuminatedsections of windows 111 and 112 to disappear.

Semi-cylindrical screen 119 then begins its rotational motion andprogressively occludes the light rays from lamp 120, thereby causing .anarea of increasing darkness or decreasing illumination to appear onwindow 113, the progression taking place in a downward direction. Thus,the illuminated area gradually decreases and, when it has reached thebottom extremity of window 113, semi-cylindrical screen 121 in turnbegins to occlude the light rays from lamp 122, thereby causing theilluminated area of window 114 to gradually diminish until completeextinction. When the initial starting position is reverted to in thisway, peg 119:1 of screen 119 moves contact 153 into its operativeposition, and the initial effect of this is to cut off the energizationof electromagnet 151 and to thereby cause screen 119 to be released.Screen 119 and screen 117 then revert to their inoperative positions inresponse to their return springs. In addition, opening of contact 151bcauses the supply to lamps 120 and 122 to be cut off. Lastly, thetransition of contact 153 to its operative position causes the firstengagement electromagnet 149 to be energized and rotation of screen 115to be resumed, thus beginning a fresh cycle.

It will be seen, therefore, that in windows 111, 112, 113 and 114, whichare respectively associated to the inhalation, breath-holding,exhalation and breath-holding phases of the breathing cycle, thereappear progressively increasing or decreasing illuminated areas, as thecase may be. The patient then matches his breathing rhythm to the rateof progression of these luminous images and is free to choose thefrequency of image succession, i.e. the duration of the breathing cycle,by energizing the appropriate electromagnet 141 to 146.

The time base of the various cycles can very easily be modiiied bychanging the transmission ratios of the various pinion assemblies. It isalso possible to eiect twoor three-stage respiration cycles by changingthe board 103 and modifying the settings yof the semi-cylindricalscreen.

Reference is now had to FIGURE 7, in which it will be seen that knob 109controls a selector 109a adapted to place the winking lamp 108 out ofcircuit, to supply it with constant current, or to place it in serieswith a contact 181 controlled by a cam 182 which is rotated by the inputshaft to produce the winking effect.

Similarly, the apparatus can be equipped with a knob to enable thebrightness of the various light sources to be adjusted to suit thesurrounding lighting conditions.

What I claim is:

1. An apparatus for imposing a respiration cycle consisting ofsuccessive inhalation, breath-holding, exhalation and breath-holdingphases, respectively, in particular for inducing psychosomaticrelaxation, comprising an electric motor, a board, lirst illuminatingmeans thereon to indicate the inhalation phase of the respiration cycleto the patient, second illuminating means on said board to indicate abreath-holding phase of the respiration cycle to the patient, thirdilluminating means on said board to indicate an exhalation phase of therespiration cycle to the patient, fourth illuminating means on saidboard to indicate a breath-holding phase of the respiration cycle to thepatient, said first, second, third and fourth illuminating meansconsisting of illuminated areas the dimensions of which varycontinuously and being so arranged in succession as to form asubstantially continuous trace on said board, each of said illuminatingmeans comprising in conjunction with each illuminated area, -a lightsource, a screen for occluding the light therefrom and means for movingsaid screen by said electric motor in relation to said source so that acontinuously varying illuminated area be projected on said board.

2. An apparatus as claimed in claim 1, wherein said illuminating meanscomprises a plurality of elongated windows each of which is associatedwith a phase of the respiration cycle respectively, and, behind each oneof said Windows, a semi-cylindrical screen, a lamp positioned withinsaid semi-cylindrical screen, and means for rotating said screen aboutits axis so as to cause its shadow to be projected onto the associatedwindow.

3. An apparatus as claimed in claim 2 wherein at least one window isvertical and the semi-cylindrical screen projecting a shadow thereon hasa horizontal axis.

4. An apparatus as claimed in claim 2, wherein at least one window ishorizontal and the semi-cylindrical screen for projecting a shadow ontosaid horizontal window has a vertical axis.

5. An apparatus as claimed in claim 2 comprising a mobile support formounting each lamp projecting the shadow of its associatedsemi-cylindrical screen and a cam for so moving said mobile support thatthe rate of travel of the illuminated area on said board besubstantially constant.

6. An apparatus as claimed in claim 2, comprising a timer drivendirectly by said electric motor, a driving shaft, a plurality ofcoupling means providing dilferent transmission ratios interposedbetween said motor and said driving shaft, speed engagementelectromagnets each of which controls one of said coupling means, andmeans for rotating the semi-cylindrical screens from said driving shaft.

7. An apparatus as claimed in claim 6, comprising means whereby thesemi-cylindrical screen producing an illuminated area associated withone of the phases of the respiration cycle rotates that semi-cylindricalscreen which produces the illuminated area associated with the nextphase of the respiration cycle.

8. An apparatus as claimed in claim 6, comprising a remote controldevice which consists o-f a starting button and a plurality ofpush-buttons respectively associated with a dilerent duration of therespiration cycle and which selectively controls the energization ofsaid speed engagement electromagnets, and means for energizing asemi-cylindrical screen coupling electromagnet when said starting buttonis depressed.

References Cited bythe Examiner UNITED STATES PATENTS 1,959,217 5/1934Pieper 12S-76.5 2,718,227 9/ 1955 Powell 12S-7645 2,934,060 4/ 1960Satter 128-1 FOREIGN PATENTS 670,789 4/ 1952 Great Britain.

RICHARD A. GAUDET, Primary Examiner.

1. AN APPARATUS FOR IMPOSING A RESPIRATION CYCLE CONSISTING OFSUCCESSIVE INHALATION, BREATH-HOLDING, EXHALATION AND BREATH-HOLDINGPHASES, RESPECTIVELY, IN PARTICULAR FOR INDUCING PSYCHOSMATICRELAXATION, COMPRISING AN ELECTRIC MOTOR, A BOARD, FIRST ILLUMINATINGMEANS THEREON TO INDICATE THE INHALATION PHASE OF THE RESPIRATION CYCLETO THE PATIENT, SECOND ILLUMINATING MEANS ON SAID BOARD TO INDICATE ABREATH-HOLDING PHASE OF THE RESPIRATION CYCLE TO THE PATIENT, THIRDILLUMINATING MEANS ON SAID BOARD TO INDICATE AN EXHALATION PHASE OF THERESPIRATION CYCLE TO THE PATIENT, FOURTH ILLUMINATING MEANS ON SAIDBOARD TO INDICATE A BREATH-HOLDING PHASE OF THE RESPIRATION CYCLE TO THEPATIENT, SAID FIRST, SECOND, THIRD AND FOURTH ILLUNINATING MEANSCONSISTING OF ILLUMINATED AREAS THE DIMENSIONS OF WHICH VARYCONTINUOUSLY AND BEING SO ARRANGED IN SUCCESSION AS TO FORM ASUBSTANTIALLY CONTINUOUS TRACE ON SAID BOARD, EACH OF SAID ILLUMINATINGMEANS COMPRISING IN CONJUNCTION WITH EACH ILLUMINATED AREA, A LIGHTSOURCE, A SCREEN FOR OCCLUDING THE LIGHT THEREFROM AND MEANS FOR MOVINGSAID SCREEN BY SAID ELECTRIC MOTOR IN RELATION TO SAID SOURCE SO THAT ACONTINUOUSLY VARYING ILLUMINATED AREA BE PROJECTED ON SAID BOARD.